General Anesthesia Management Guidelines

Induction – Short‑acting Muscle Relaxant

• Succinylcholine administered at ≈ 1 mg per kg of actual body weight is recommended as the short‑acting neuromuscular blocker for rapid sequence induction. [1][2]3

Opioid Analgesia During Maintenance

• Opioid infusion options include a remifentanil infusion at ≈ 0.05 µg kg⁻¹ min⁻¹ or intermittent fentanyl boluses, tailored to the surgical stimulus. 4

Neuromuscular Blockade Reversal

• Reversal agents should be given once the train‑of‑four (TOF) ratio exceeds 90 % to ensure adequate recovery of muscle strength. [1][2]

Pharmacologic Reversal of Specific Agents

• Naloxone should be readily available for rapid reversal of opioid‑induced respiratory depression when required. 5
• Flumazenil should be readily available for reversal of benzodiazepine effects if clinically indicated. 5

Extubation Criteria

• Extubation is considered safe when all of the following are met: